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Abstract

BMI is often used to assess risk of cardiovascular disease (CVD); however, current BMI cutpoints may not be accurate for all ethnicities. Given the high prevalence of obesity and type 2 diabetes in Hispanics, it is important to examine whether current BMI cutpoints accurately identify those at healthy weight and those at risk. We examined whether there was a difference in CVD risk factors within the normal-weight BMI category in young, Hispanic women. We hypothesized that women in the highest tertile of normal-weight would have significantly more CVD risk factors than those in the lowest tertile of normal-weight. Sixty nine normal-weight Hispanic women (20-39 y) were divided into tertiles of normal-weight BMI: 18.5-20.9 kg/m2 (NW low, n=17), 21.0-22.9 kg/m2 (NW mid, n=31) and 23.0-24.9 kg/m2 (NW high, n=21). CVD risk factors measured included waist circumference, blood pressure and fasting glucose, triglycerides and high-density and low-density lipoprotein. Glucose tolerance was measured by a 2h oral glucose tolerance test. Body composition was measured by dual-energy x-ray absorptiometry. Intra-abdominal adipose tissue, an estimate of visceral adiposity, was calculated. Data were analyzed using multivariate ANOVA, with Levine’s test indicating homogeneity of variances among groups, and Kruskal-Wallace test. Post hoc tests included Bonferroni and Mann Whitney. Results indicated the prevalence of women who were risk factor free was 65%, 39% and 24% for NW low, mid and high, respectively. The prevalence of women with one or more CVD risk factors was 35%, 61%, and 76% for NW low, mid and high, respectively. The prevalence of women with two or more CVD risk factors was 0%, 3%, and 29% for NW low, mid and high, respectively. The prevalence of women with three or more CVD risk factors was 0%, 0% and 10% for NW low, mid and high, respectively. Overall the prevalence of CVD risk factors was significantly higher in NW high than NW low (p=0.006) and NW mod (p=0.04) and approached significance between NW mid and NW low (p=0.08). There was a significant increase in percentage body fat (27.6±5.1%, 30.7±4.6%, 36.9±4.6%, respectively), intra-abdominal adipose tissue (24.2±7.9 cm2, 45.6±12.2 cm2, 66.5±19.7 cm2, respectively), and waist circumference (71.2±3.1 cm, 76.6±4.8 cm, 81.0±5.8 cm, respectively) from NW low to NW high (p<0,001). NW high had significantly higher triglyceride levels than NW low (86.4±40.0 mg/dL vs. 58.9±20.6 mg/dL, p=0.04) and significantly higher 2h glucose levels than NW mid (120.0±27.9 mg/dL vs. 99.1±17.3 mg/dL, p=0.003). In conclusion, young, Hispanic women at the upper-end of the normal-weight BMI range had a significantly higher prevalence of CVD risk factors, body fat and central obesity than women in the mid and lower end of normal-weight BMI range. These findings suggest that the normal-weight BMI cutpoint may need to be adjusted for Hispanic women.